PB2119: REDUCED OVERALL SURVIVAL OF MULTIPLE MYELOMA PATIENTS DURING THE COVID-19 PANDEMIC
Authors: Alexander Luchinin, Elena Osipova, Natalia Minaeva
Journal: HemaSphere (2023)

Topic: 14. Myeloma and other monoclonal gammopathies - Clinical Background: Multiple myeloma (MM) is a prevalent blood cancer disease. In recent 20 years, the overall survival (OS) of MM patients has seen a significant improvement as a result of the availability of autologous hematopoietic stem cell transplantation and the introduction of new medications. But the COVID-19 pandemic has been identified as a contributing factor to the excess mortality of MM patients, given their compromised immune state. Some studies have demonstrated that MM patients have a lower efficacy rate for vaccination against COVID-19, frequently require ICU hospitalization, and have a higher mortality rate. Aims: To evaluate the OS of patients with MM from 1995 to 2022, inclusive of the time frame of the COVID-19 pandemic. Methods: We obtained information on 835 patients (336 men, 499 women) with a newly diagnosed MM from a population-based registry. These patients received their diagnosis between January 1st, 1995, and December 31st, 2022, in Kirov Research Institute of Hematology and Blood transfusion. The total duration of follow-up was 27 years. The study population was composed of 40% men and 60% women. The median age of patients at the time of diagnosis was 63 years (range 55-71 years). The OS was analyzed using the Kaplan-Meier method and was defined as the time from diagnosis to death due to any cause in cases of complete follow-up, or to the known date of last follow-up in cases of censored follow-up, for patients who were still alive at that time. Results: The stage of MM according to Durie-Salmon classification was verified in 553 patients, including: IA stage - 49 (9%) patients, IIA - 220 (40%), IIB - 2 (<1%), IIIA - 196 (35%), IIIB - 86 (16%). The immunochemical variant of MM was determined in 754 patients, of whom: IgG myeloma - 436 (58%), IgA - 167 (22%), Bence Jones myeloma - 113 (15%), IgM - 6 (<1%), IgD - 2 (<1%), IgE - 1 (<1%) and non-secreting form - 29 (4%). The median OS in the overall group was 45 months (95% CI 41-49 months) and the 5-year OS was 39%. Over the past 10 years, the life expectancy of MM patients has increased significantly. Thus, from 1995 to 2012, the median OS was 2.7 years, and the 5-year OS was 29% (415 patients), whereas from 2013 to 2022, similar OS rates increased to 5.7 years and 57%, respectively (420 patients). The dynamics of OS for patients diagnosed with multiple myeloma over five-year calendar intervals is depicted in Figure 1. It is noteworthy that there is a decline in OS from 2018 to 2022 as compared to the previous interval from 2013 to 2017. The COVID-19 pandemic may be a potential explanation for this negative trend. In order to investigate this hypothesis, we examined the prevalence (number of patients diagnosed with multiple myeloma at the end of each year) and mortality (percentage of patients diagnosed with multiple myeloma who have passed away by the end of each year) over the past 20 years. From 2000 to 2019, there is a steady increase in the prevalence of multiple myeloma from 61 to 170 patients, which is followed by a sharp decline in 2020 and 2021 to 151 patients. This calendar period coincides with the high prevalence of COVID-19 and increasing global mortality rates. These results are also consistent with the annual multiple myeloma mortality rates at our center, which remained low from 2012 to 2018 about 6-8%. However, there is a sharp increase in mortality from 2019 to 2021 to 18%, which is also linked to the COVID-19 pandemic. Beginning in 2022, the multiple myeloma mortality and prevalence rates began to return to pre-pandemic levels. Summary/Conclusion: Therefore, the data suggests that the COVID-19 pandemic between 2020 and 2021 may have led to an increase in mortality among MM patients and had a negative impact on their OS.Fig. 1. Overall survival of MM patients at different follow-up periods Keywords: Survival, COVID-19, Multiple myeloma